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<title>Aplicación Web Agencia Naviera | Homepage</title>
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		<h1><a href="#">Aplicación Web Agencia Naviera</a></h1>
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			<h2></h2>
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		<form  class="searching" action="">
		<fieldset>
			<label>Searching</label>
				<input class="search" type="text" onfocus="if(this.value==this.defaultValue)this.value=''" 
				onblur="if(this.value=='')this.value=this.defaultValue" value="Search term&hellip;" />
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			<li class="first"><a href="#" class="active">Home</a></li>
			<li><a href="cliente.html">Registro de Cliente</a></li>
			<li><a href="embarque.html">Registro de Embarque</a></li>
			<li><a href="#"></a></li>
			<li><a href="#"></a></li>
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				<div id="content-box-in-left-in">
					<h3>Registro de Cliente</h3>
						
						<p></p>
						
						
						
<div id="container">
<fieldset>
<legend></legend>
<form id="registrocliente" name="registrocliente" class="wufoo topLabel page" autocomplete="off" enctype="multipart/form-data" method="post" novalidate
action="">

<ul>

<li id="foli0" class="complex     ">
<label class="desc" id="title0" for="Field0">
Cliente
</label>
</li>
<li>
<span>
<label for="Field0">Nombres:</label>
</span>
<span>
<input id="Field0" name="Field0" type="text" class="field text fn" value="" size="30" tabindex="1" />
</span>
</li>
<li>
<span>
<label for="Field1">Apellidos:</label>
</span>
<span>
<input id="Field1" name="Field1" type="text" class="field text ln" value="" size="30" tabindex="2" />
</span>
</li>
<li>
<span>
<label for="Field0">Razón Social:</label>
</span>
<span>
<input id="Field0" name="Field0" type="text" class="field text fn" value="" size="30" tabindex="1" />
</span>
</li>
<li>
<span>
<label for="Field1">RUC:</label>
</span>
<span>
<input id="Field1" name="Field1" type="text" class="field text ln" value="" size="30" tabindex="2" />
</span>
</li>
<li>
<span>
<label for="Field1">Tipo Documento:</label>
</span>
<span>
<input id="Field1" name="Field1" type="text" class="field text ln" value="" size="30" tabindex="2" />
</span>
</li>
<li>
<span>
<label for="Field1">Número de Documento:</label>
</span>
<span>
<input id="Field1" name="Field1" type="text" class="field text ln" value="" size="30" tabindex="2" />
</span>
</li>



<li id="foli2" class="complex      ">
<label class="desc" id="title2" for="Field2">
Address
<span id="req_2" class="req">*</span>
</label>
<div>
<span class="full addr1">
<input id="Field2" name="Field2" type="text" class="field text addr" value="" tabindex="3" required />
<label for="Field2">Street Address</label>
</span>
<span class="full addr2">
<input id="Field3" name="Field3" type="text" class="field text addr" value="" tabindex="4" />
<label for="Field3">Address Line 2</label>
</span>
<span class="left">
<input id="Field4" name="Field4" type="text" class="field text addr" value="" tabindex="5" required />
<label for="Field4">City</label>
</span>
<span class="right">
<input id="Field5" name="Field5" type="text" class="field text addr" value="" tabindex="6" required />
<label for="Field5">State / Province / Region</label>
</span>
<span class="left">
<input id="Field6" name="Field6" type="text" class="field text addr" value="" maxlength="15" tabindex="7" required />
<label for="Field6">Postal / Zip Code</label>
</span>
<span class="right">
<select id="Field7" name="Field7" class="field select addr" tabindex="8" >
<option value="" selected="selected"></option>
<option value="United States">United States</option>
<option value="United Kingdom">United Kingdom</option>
<option value="Australia">Australia</option>
<option value="Canada">Canada</option>
<option value="France">France</option>
<option value="New Zealand">New Zealand</option>
<option value="India">India</option>
<option value="Brazil">Brazil</option>
<option value="----">----</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Åland Islands">Åland Islands</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia">Bolivia</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Democratic Republic of the Congo">Democratic Republic of the Congo</option>
<option value="Republic of the Congo">Republic of the Congo</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="C&ocirc;te d'Ivoire">C&ocirc;te d'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="East Timor">East Timor</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Greece">Greece</option>
<option value="Grenada">Grenada</option>
<option value="Guatemala">Guatemala</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran">Iran</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="North Korea">North Korea</option>
<option value="South Korea">South Korea</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Laos">Laos</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macedonia">Macedonia</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia">Micronesia</option>
<option value="Moldova">Moldova</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="Netherlands Antilles">Netherlands Antilles</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestine">Palestine</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Romania">Romania</option>
<option value="Russia">Russia</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia and Montenegro">Serbia and Montenegro</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syria">Syria</option>
<option value="Taiwan">Taiwan</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania">Tanzania</option>
<option value="Thailand">Thailand</option>
<option value="Togo">Togo</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Vatican City">Vatican City</option>
<option value="Venezuela">Venezuela</option>
<option value="Vietnam">Vietnam</option>
<option value="Virgin Islands, British">Virgin Islands, British</option>
<option value="Virgin Islands, U.S.">Virgin Islands, U.S.</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
<label for="Field7">Country</label>
</span>
</div>
</li>
<li id="foli8" class="phone leftHalf     ">
<label class="desc" id="title8" for="Field8">
Phone
</label>
<span>
<input id="Field8" name="Field8" type="tel" class="field text" value="" size="3" maxlength="3" tabindex="9" />
<label for="Field8">###</label>
</span>
<span class="symbol">-</span>
<span>
<input id="Field8-1" name="Field8-1" type="tel" class="field text" value="" size="3" maxlength="3" tabindex="10" />
<label for="Field8-1">###</label>
</span>
<span class="symbol">-</span>
<span>
 <input id="Field8-2" name="Field8-2" type="tel" class="field text" value="" size="4" maxlength="4" tabindex="11" />
<label for="Field8-2">####</label>
</span>
</li>
<li id="foli9" class="rightHalf     ">
<label class="desc" id="title9" for="Field9">
Email
<span id="req_9" class="req">*</span>
</label>
<div>
<input id="Field9" name="Field9" type="email" spellcheck="false" class="field text medium" value="" maxlength="255" tabindex="12" required /> 
</div>
</li>
<li id="foli12" class="date leftHalf     ">
<label class="desc" id="title12" for="Field12">
Arrival Date
</label>
<span>
<input id="Field12-1" name="Field12-1" type="text" class="field text" value="" size="2" maxlength="2" tabindex="13" />
<label for="Field12-1">MM</label>
</span> 
<span class="symbol">/</span>
<span>
<input id="Field12-2" name="Field12-2" type="text" class="field text" value="" size="2" maxlength="2" tabindex="14" />
<label for="Field12-2">DD</label>
</span>
<span class="symbol">/</span>
<span>
 <input id="Field12" name="Field12" type="text" class="field text" value="" size="4" maxlength="4" tabindex="15" />
<label for="Field12">YYYY</label>
</span>
<span id="cal12">
<img id="pick12" class="datepicker" src="images/calendar.png" alt="Pick a date." />
</span>
</li>
<li id="foli13" class="date rightHalf     ">
<label class="desc" id="title13" for="Field13">
Departure Date
</label>
<span>
<input id="Field13-1" name="Field13-1" type="text" class="field text" value="" size="2" maxlength="2" tabindex="16" />
<label for="Field13-1">MM</label>
</span> 
<span class="symbol">/</span>
<span>
<input id="Field13-2" name="Field13-2" type="text" class="field text" value="" size="2" maxlength="2" tabindex="17" />
<label for="Field13-2">DD</label>
</span>
<span class="symbol">/</span>
<span>
 <input id="Field13" name="Field13" type="text" class="field text" value="" size="4" maxlength="4" tabindex="18" />
<label for="Field13">YYYY</label>
</span>
<span id="cal13">
<img id="pick13" class="datepicker" src="images/calendar.png" alt="Pick a date." />
</span>
</li>
<li id="foli10" class="      ">
<label class="desc" id="title10" for="Field10">
Accommodation Status
</label>
<div>
<select id="Field10" name="Field10" class="field select medium" tabindex="19" > 
<option value="" selected="selected">
</option>
<option value="Single" >
Single
</option>
<option value="Couple" >
Couple
</option>
<option value="Group" >
Group
</option>
<option value="Family" >
Family
</option>
<option value="Roommate Selected" >
Roommate Selected
</option>
<option value="Need Roommate" >
Need Roommate
</option>
<option value="Without Accommodations" >
Without Accommodations
</option>
</select>
</div>
</li>
<li id="foli11" 
class="     "><label class="desc" id="title11" for="Field11">
Special Needs
</label>

<div>
<textarea id="Field11" 
name="Field11" 
class="field textarea medium" 
spellcheck="true" 
rows="10" cols="50" 
tabindex="20" 
onkeyup=""
 ></textarea>

</div>
</li> <li class="buttons ">
<div>

<input id="saveForm" name="saveForm" class="btTxt submit" type="submit" value="Submit"
 /></div>
</li>

</ul>
</form> 
</fieldset>
</div><!--container-->
						
						
						
						
						
						<div class="cleaner">&nbsp;</div>
						
						<p></p>
					<h3></h3>
						
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